Preparing for Health Debate, and Its TV Audience

WASHINGTON — In convening Thursday’s bipartisan health session, President Obama is angling to recreate the kind of spontaneous, unscripted debate that gave him a decided advantage when he took questions on live television at a House Republican retreat in Baltimore last month.

But this time, Mr. Obama will face adversaries who are well prepared to joust with him on the finer points of health policy before a large audience that will be judging both sides and looking for signs of bipartisanship.

From the seating arrangements to the camera positions and buffet lunch — not to mention the talking points — the meeting has been carefully orchestrated, the product of days of negotiations that led to a walk-through on Wednesday for Congressional aides at Blair House.

One way Mr. Obama could throw Republicans off stride would be to make a bold opening offer to embrace one of their health care priorities, like limiting medical malpractice lawsuits — an idea one Democrat close to the White House said had been under consideration.

But, this Democrat said, such an offer appeared unlikely, in part because Republicans seem dug in against the president’s plan and in part because it would arouse the ire of Mr. Obama’s Democratic base. In a conference call Wednesday, Congressional Democrats warned White House officials “not to go too far” on tort reform, one person familiar with the call said.

White House officials said Mr. Obama would use his opening remarks to make the case that Democrats and Republicans are not as far apart as they think on health care, because both parties are concerned about the deficit and rising health premiums — issues, the president will argue, that can be addressed only by controlling health care costs.

Republicans said they would frame their arguments in opposition to the Democrats’ expansive plan, and would emphasize a handful of ideas that were part of a House Republican alternative to the Democrats’ legislation in November, including allowing small businesses to band together to buy health insurance at lower prices, permitting the sale of insurance policies across state lines, expanding state high-risk pools to offer coverage to people who otherwise could not obtain it, and limiting damages in medical malpractice lawsuits.

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Senator Harry Reid spoke Wednesday to a group gathered in Washington to push lawmakers to pass health care legislation.Credit
Stephen Crowley/The New York Times

On Capitol Hill, both parties spent Wednesday preparing. Republicans met to plot strategy, even as they continued to deride the event as “political theater.”

At a hearing to question the president of WellPoint, one of the nation’s largest insurers, about rate increases in California, Representative Michael C. Burgess of Texas, the senior Republican on the investigations and oversight subcommittee of the Energy and Commerce panel, accused the Obama administration of trying to use the rate increases to build support for an expansive bill — and to allow the federal government to interfere with a state issue.

Senator Harry Reid, the majority leader, and Speaker Nancy Pelosi met to prepare in Ms. Pelosi’s office, as party leaders insisted the session would provide voters a fresh perspective — even though Washington has been debating health care for nearly a year.

“I honestly think it’s going to be quite constructive, because with TV cameras it’s going to force senators and representatives, both sides, to not over-dramatize but to burrow down on what health care reform does and does not make sense,” said Senator Max Baucus, Democrat of Montana. “I just believe in the disinfectant of the sunshine. The more we have got questions on both sides, gradually the American people are going to see more and more and more that we really do need health care reform.”

As the parties readied themselves, House Democrats were busy counting votes on Wednesday. The Democratic whip, Representative James E. Clyburn of South Carolina, said he believed Democrats could muster the votes to adopt a health care bill that resembled the plan Mr. Obama laid out on Monday, even picking up votes from some Democrats who opposed the House bill that was adopted in November.

Amid Wednesday’s political maneuvering, there was also legislative action. By a vote of 406 to 19, the House passed a bill to eliminate the exemption from federal antitrust law that health insurance companies have long enjoyed. The vote was a rare example of bipartisanship: 253 Democrats and 153 Republicans voted in favor, though all the no votes were cast by Republicans.

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Seating arrangements and camera positions at Blair House have been negotiated. On Thursday, talk will turn to health care.Credit
Luke Sharrett/The New York Times

The repeal was included in the House version of health care legislation, but with the big bill stalled by the prospect of a Republican filibuster in the Senate, House Democratic leaders moved forward with a stand-alone measure as part of a strategy to continue advancing popular components of the larger bill.

“For too long,” said Representative Maxine Waters, Democrat of California, “consumers have been ripped off by collusion and concentration in the health insurance industry.”

The tussle over the staging of Thursday’s meeting suggests the extent to which each side is trying to use it to make overtures not to each other, but to the viewing public. The talks grew especially intense over the seating arrangements, Republican officials said, when the White House at first proposed a U-shaped table with President Obama and Vice President Joseph R. Biden Jr. in the center and Congressional leaders around the sides.

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But the table would not have been big enough to accommodate all the lawmakers, pushing some into the chairs reserved for staff members. Republicans balked, and the White House agreed to close the U, so the lawmakers will now be seated around a hollow O-shaped table. Republicans, remembering well how Mr. Obama addressed them from a lectern at the Baltimore event, said it was important for them to have a level playing field.

“Any time you can be on equal footing with the president of the United States in style, set aside substance, you’re ahead of the game,” said Kenneth Duberstein, a former chief of staff to President Ronald Reagan. “The meeting at Blair House is not about the participants in the room, it’s about the TV audience.”

One lawmaker who sparred with Mr. Obama at the Baltimore meeting, Representative Jeb Hensarling of Texas, said he did not have high hopes for Thursday’s session. “I am having a hard time taking the whole thing seriously,” he said.

But Mr. Hensarling, whom Mr. Obama mistakenly called “Jim” in Baltimore, said such forums could help officials get to know one another better and hear others’ ideas.

“I personally think that although the president didn’t know me before the retreat,” Mr. Hensarling said, “he may know me now.”

Robert Pear contributed reporting.

A version of this article appears in print on February 25, 2010, on Page A20 of the New York edition with the headline: Preparing in Great Detail for a Health Debate, and for Its TV Audience. Order Reprints|Today's Paper|Subscribe